Disorders of the Immune Response, chap 16 Flashcards

1
Q

Innate Immunity: “natural immunity”

A

> Early rapid response (min-hrs). First line of defence

> physical, chemical, molecular, and cellular defenses that are in place bfr infection

> able to recognize self/non-self

> reacts to microbes (bc these are non-self)

> skin, mucous membrane, phagocytic leukocytes** (neutrophils and macrophages), specialized lymphocytes (NK cells), and several plasma proteins.

> complement system- assists antibodies and phagocytes to destroy pathogens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Adaptive Immunity:

A

> second major immune defense.

> responds less rapid, but more effectively to : infection, tumor cells, transplanted cells

> uses focused recognition of each foreign agent

> B-cell (type of WBC)- secretes antibodies
T-cell- directed by B-cell activity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Hypersensitivity

A

> excessive or inappropriate activation of the immune response

> the body is damaged by the body rather than the antigen (often called allergen)
–cell death that shouldn’t have happened. The bodies response damages the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Type 1 Hypersensitivity

Allergic, Anaphylaxis, Atopy

A

“allergic rxn”

> systemic or anaphylactic reactions

> local or atopic reactions:

  1. Rhinitis
  2. Food
  3. Bronchial asthma
  4. Hives
  5. Atopic Dermatitis - hives and eczema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Anaphylaxis

A

Type 1 hypersensitivity

Systemic response to the inflammatory mediators released in type 1 hyper
– Histimine, acetylcholine, kinins, leukotrines, and prostaglandins cause = vasodilation and decreased BP.

– acetylcholine, kinins, leukotrines, and prostaglandins cause = bronchoconstriction

Tx: epinephrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Type 2 hypersensitivity

AntiBody

A
  • -Cytotoxic- toxic to that cell
    • IgG or IgM attack antigens on cell surfaces
  1. Results in Cell Lysis (opsonization)
    - - ABO blood incompatibility (transfusion reaction)
    - - Rh disease (hemolytic disease of new born)
    - - drug reaction
  2. Results in Inflammatory Process
    - - Glomerulonephritis, transplant rejection
  3. Results in Cell Dysfunction
    - - Graves disease- over active thyroid
    - - Myasthenia Gravis- acetacholine or receptor blocked. muscle weakness with out atrophy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Type 3 Hypersensitivity

Immune Complex

A

Circulating inactive antigen + antibody immune complex – causes deposit on walls of blood vessels and activate complement

> Immune complexes deposit on the walls of blood vessels and activate complement = Inflammation

> Blood vessels are damaged
Ex.
–Autoimmune vasculitis- inflam of blood vessel
– Glomerulonephritis
– Systemic Lupus Erythematosus (SLE)- autoimmune attacks healthy tissue
– Serum sickness- drug reaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Type 4 Hypersensitivity

Delayed

A

does not involve antibodies
Cell-mediated: Sensitized TH1 cells attack antigen and cell damaged as a result
– occurs even if pathogen is not harming cell
– ex. some types of hepatitis

2 types:

  1. Direct cell-mediated cytotoxicity
    - - viral infections
  2. Delayed-Type Hypersensitivity
    - -TB test
    - - Allergic contact dermatitis. ex. poison ivy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Autoimmune Diseases

A

Self-tolerance is ability to differentiate self from non-self

– Maintained by “central tolerance” which deletes T and B cells (in thymus and bone marrow)

–Maintained by “peripheral tolerance” which deletes activated T and B cells

If immune system is unable to differentiate, body tissues are destroyed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Immunodeficiency Disorders

A
  1. Primary- (congenital or inherited)
    - -B-cell deficiencies
    - - T-cell deficiencies: CD4 helper and CD8 cytotoxic
    - - Combines Immunodeficiency’s
  2. Acquired (more common)
    - - AIDS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Acquired Immunodeficiency Syndrome (AIDS)

A

Caused by Human Immunodeficiency Virus (HIV) which attacks the CD4 T cell receptors.

> HIV attaches to the CD4 T-cell receptors
enters the cell
attaches own RNA to cells DNA
uses cells energy to reproduce more virusus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

AIDS results in: 5

A
  1. Profound Immunosuppression
  2. Malignancies
  3. Opportunistic infections
  4. Wasting
  5. CNS degeneration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Human Immunodeficiency Virus (HIV):

A

Transmitted by blood/body fluids:
> pre-ejaculate, semen, vag fluid (not saliva or urine)
> breast milk 30-40%
> blood to blood contact :
– needle sharing
– transfusions
– During pregnancy or birth: in-urtero 15-20% and during labor/delivery 45-50%

> Occupational exposure uncommon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Stages of HIV:

Stage 1 : Primary infection phase

A

> signs of systemic infection 1-4 weeks post exposure

  • -fever, fatigue, sore throat, night sweats, GI issues, lymphadenopathy, muscular rash, ha
  • -lasts 7-10 days

> Rapid viral replication decreases CD4 t-cell count

Seroconversion: Immune system responds and antibodies against HIV appear 1-6 months and have started to develop the antibodies

***Most contagious during “window period” for 1-6 months prior to seroconversion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Stages of HIV:

Stage 2 : Latent Period

A
> aprox 10 years
> no signs and symp
>virus is replicating 
> CD$ count drops
>possible lymphadenopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Stages of HIV:

Stage 3 : Overt AIDS

A

> T-cell count low

> Death in 2-3 years without tx

17
Q

AIDS associated illnesses: 3

A

Opportunistic infections (immune system compromised)

    • infections caused by organisms that would normally not
    • catagorized by organism type
  1. Respiratory
  2. GI
  3. Nervous System
18
Q

AIDS: Respiratory Infections 3

A

bacterial pneumonia, P. jiroveci pneumonia, pulmonary TB

> P. Jiroveci

  • -common fungus in environment
    • multiplies quickly in the HIV infected lungs
    • foamy exudate forms cysts in the alveoli
    • milf cough, fever, SOB, weight loss

> TB

    • usually in lung but also in kidney, bone marrow, ect.
    • fever, night sweats, cough, weight loss
19
Q

AIDS: GI Infections 3

A
  1. Esophagitis
    - - esophageal candidiasis, chlamydial virus, herpes simples
  2. Aphthous Ulcers
    - - cause painful swallowing, retrosternal pain
  3. Gasteroenteritis
    - - mild to severe diarrhea
20
Q

AIDS: Nervous system disorders 3

A

*Often late stage of AIDS

  1. HANDs (HIV assosicated neurocognitive disorder)
    - - syndrome of cognitive and motor dysfunction, with behavioral and psychosocial symptoms
    - - Attention/concentration deficit, mental/motor slowing, apathy
  2. Toxoplasmosis (parasitic)
    - - cat feces, raw meat
    - - fever, ha, confusion, lethargy, visual disturbances, seizures
  3. Progressive Multifocal Leukoencephalopathy
    - - slow demylination of white matter d/t virus
    - - progressive limb weakness, hemi-paresis, ataxia
    - - sensory loss, visual disturbances
    - - mental status changes, seizures
21
Q

AIDS: Malignancies 4

A
  1. Kaposi Sarcoma (KS)
    - - common
    - - endothilial lining of small blood vessels
    - -Oral and skin lesions, GI tract, lungs
    - -» violet, lesions enlarged darkened
    - -» often of trunk, head, neck, tip of nose
    - -» painless as first
    - -» invade tissues (late pulm invasion)
  2. Non-Hodgkin lymphoma (blood ca)
    - - fever, night sweats, weight loss
  3. Cervical carcinoma
    - - HPV
  4. Anal carcinoma
22
Q

AIDS: Wasting syndrome

A

Diagnosed in the absence of opportunistic infection or malignancy

Causes:
> Malabsorption, endocrine dysfunction ect.

Manifestations:
> invol weight loss > 10% of baseline body weight- can eat and eat and still loss weight
> Diarrhea/ multiple daily stool
> chronic weakness
> Fever
23
Q

AIDS: Metabolic Disorders

A

> Insulin resistane, DM, hyperlipidemia, lipodystrophy, mitochondrial disorders
often d/t treatment regimens